Parental adiposity differentially associates with newborn body composition.

BACKGROUND: Maternal obesity increases offspring's obesity risk. However, studies have not often considered maternal metabolic and exercise patterns as well as paternal adiposity as potential covariates. OBJECTIVE: To assess the relationship between parental and newborn adiposity. METHODS: Participants were mother-child pairs (n = 209) and mother-father-offspring triads (n = 136). Parental (during gestation) and offspring (2 weeks old) percent fat mass (FM) were obtained using air displacement plethysmography. Maternal race, age, resting energy expenditure (indirect calorimetry), physical activity (accelerometry), gestational weight gain (GWG), gestational age (GA), delivery mode, infant's sex and infant feeding method were incorporated in multiple linear regression analyses. The association between parental FM and offspring insulin-like growth factor 1 (IGF-1) was assessed at age 2 years. RESULTS: Maternal adiposity was positively-associated with male (ß = 0.11, P = .015) and female (ß = 0.13, P = .008) infant FM, whereas paternal adiposity was negatively-associated with male newborn adiposity (ß = -0.09, P = .014). Breastfeeding, female sex, GA and GWG positively associated with newborn adiposity. Vaginal and C-section delivery methods associated with greater adiposity than vaginal induced delivery method. Plasma IGF-1 of 2-year-old boys and girls positively associated with their respective fathers' and mothers' FM. CONCLUSIONS: Maternal and paternal adiposity differentially associate with newborn adiposity. The mechanisms of this finding remain to be determined.

A Behavioral Intervention to Reduce Excessive Gestational Weight Gain.

Objectives Excessive gestational weight gain (GWG) is a key modifiable risk factor for negative maternal and child health. We examined the efficacy of a behavioral intervention in preventing excessive GWG. Methods 230 pregnant women (87.4 % Caucasian, mean age = 29.2 years; second parity) participated in the longitudinal Glowing study (clinicaltrial.gov #NCT01131117), which included six intervention sessions focused on GWG. To determine the efficacy of the intervention in comparison to usual care, participants were compared to a matched contemporary cohort group from the Arkansas Pregnancy Risk Assessment Monitoring Survey (PRAMS). Results Participants attended 98 % of intervention sessions. Mean GWG for the Glowing participants was 12.7 ± 2.7 kg for normal weight women, 12.4 ± 4.9 kg for overweight women, and 9.0 ± 4.2 kg for class 1 obese women. Mean GWG was significantly lower for normal weight and class 1 obese Glowing participants compared to the PRAMS respondents. Similarly, among those who gained excessively, normal weight and class 1 obese Glowing participants had a significantly smaller mean weight gain above the guidelines in comparison to PRAMS participants. There was no significant difference in the overall proportion of the Glowing participants and the proportion of matched PRAMS respondents who gained in excess of the Institute of Medicine GWG guidelines. Conclusions for Practice This behavioral intervention was well-accepted and attenuated GWG among normal weight and class 1 obese women, compared to matched participants. Nevertheless, a more intensive intervention may be necessary to help women achieve GWG within the Institute of Medicine's guidelines.

Association of Gestational Weight Gain Expectations and Advice on Actual Weight Gain.

OBJECTIVE: To examine pregnant women's gestational weight gain expectations and advice from various sources (ie, self, family and friends, physician) and the association of these sources of expectations and advice with measured gestational weight gain. METHODS: This is a secondary analysis of a cohort study of 230 pregnant women in their second pregnancy. Each woman was queried at 12 weeks of gestation about the amount of weight: 1) she felt was "healthy" to gain, 2) she expected to gain, 3) her friends and family thought she should gain, and 4) the specificity of her physician's advice about gestational weight gain. Gestational weight gain was calculated as the difference in measured weight between 4 and 10 weeks and 36 weeks of gestation. Odds ratios and corresponding 95% confidence intervals were computed for the association between excessive gestational weight gain and each question using logistic regression in this secondary analysis. RESULTS: Participants were 87.4% Caucasian. Overweight and obese women were significantly more likely to expect excessive gestational weight gain compared with normal-weight women. Women who reported expecting to gain excessively were significantly more likely to actually gain excessively (52%; odds ratio [OR] 3.19, 95% confidence interval [CI] 1.77-5.77) than those who expected to gain within the guidelines (36%). After adjusting for self-reported gestational weight gain in the first pregnancy and sociodemographic characteristics, women who reported expecting to gain excessively were still significantly more likely to gain excessively (51%; OR 2.22, 95% CI 1.08-4.56) than those who expected to gain within guidelines (37%). CONCLUSION: It may be particularly important to develop interventions that positively influence women's own expectations for gestational weight gain. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01131117.

Are early first trimester weights valid proxies for preconception weight?

BACKGROUND: An accurate estimate of preconception weight is necessary for providing a gestational weight gain range based on the Institute of Medicine's guidelines; however, an accurate and proximal preconception weight is not available for most women. We examined the validity of first trimester weights for estimating preconception body mass index category. METHODS: Under identical measurement conditions, preconception weight and two first trimester weights (i.e., 4-10 and 12 weeks gestation) were obtained (n = 43). RESULTS: The 4-10 week and the 12 week weight correctly classified 95 and 91% women, respectively. Mean weight changes were relatively small overall (M = 0.74 ± 1.99 kg at 4-10 weeks and M = 1.02 ± 2.46 at 12 weeks). There was a significant difference in mean weight gain by body mass index category at 4-10 weeks (-0.09 ± 1.86 kg for normal weight participants vs. 1.61 + 1.76 kg for overweight/obese participants, p = 0.01), but not at 12 weeks (0.53 ± 2.29 kg for normal weight participants vs. 1.54 ± 2.58 kg for overweight/obese participants). CONCLUSIONS: Assigning gestational weight gain guidelines based on an early first trimester weight resulted in 5-9% of women being misclassified depending on the gestational week the weight was obtained. Thus, most women are correctly classified based on a first trimester weight, particularly an early first trimester weight, although it is possible that modeling strategies could be developed to further improve estimates of preconception body mass index category. TRIAL REGISTRATION: Clinicaltrials.gov # NCT01131117 , registered May 25, 2010.

There's more to food store choice than proximity: a questionnaire development study.

BACKGROUND: Proximity of food stores is associated with dietary intake and obesity; however, individuals frequently shop at stores that are not the most proximal. Little is known about other factors that influence food store choice. The current research describes the development of the Food Store Selection Questionnaire (FSSQ) and describes preliminary results of field testing the questionnaire. METHODS: Development of the FSSQ involved a multidisciplinary literature review, qualitative analysis of focus group transcripts, and expert and community reviews. Field testing consisted of 100 primary household food shoppers (93% female, 64% African American), in rural and urban Arkansas communities, rating FSSQ items as to their importance in store choice and indicating their top two reasons. After eliminating 14 items due to low mean importance scores and high correlations with other items, the final FSSQ questionnaire consists of 49 items. RESULTS: Items rated highest in importance were: meat freshness; store maintenance; store cleanliness; meat varieties; and store safety. Items most commonly rated as top reasons were: low prices; proximity to home; fruit/vegetable freshness; fruit/vegetable variety; and store cleanliness. CONCLUSIONS: The FSSQ is a comprehensive questionnaire for detailing key reasons in food store choice. Although proximity to home was a consideration for participants, there were clearly other key factors in their choice of a food store. Understanding the relative importance of these different dimensions driving food store choice in specific communities may be beneficial in informing policies and programs designed to support healthy dietary intake and obesity prevention.

Stress management-augmented behavioral weight loss intervention for African American women: a pilot, randomized controlled trial.

The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week adaptation of the Diabetes Prevention Program Lifestyle Balance intervention augmented with stress management strategies (Lifestyle + Stress) or Lifestyle Alone. A trend toward greater percentage of baseline weight loss at 3-month data collection was observed in Lifestyle + Stress (-2.7 ± 3.6%) compared with Lifestyle Alone (-1.4 ± 2.3%; p = .17) and a greater reduction in salivary cortisol (Lifestyle + Stress: -0.2461 ± 0.3985 ng/mL; Lifestyle Alone: -0.0002 ± 0.6275 ng/mL; p = .20). These promising results suggest that augmenting a behavioral weight control intervention with stress management components may be beneficial for overweight/obese AA women with moderate to high stress levels and merit further investigation with an adequately powered trial.